A state legislation that could have improved the quality of health care services provided by Medi-Cal managed care plans and reduce health disparities got the red light from the governor, leaving health advocates disappointed on that outcome.

Gov. Jerry Brown vetoed on Sept. 10 the legislation AB 2275 - Medi-Cal managed care: quality assessment and performance improvement which was introduced by assembly member Joaquín Arámbula, D-Fresno in February of 2018.

The bill would had require the State Department of Health Care Services to establish a quality assessment and performance improvement program for all Medi-Cal managed care plans, through which the plans would be required to meet annual improvements in quality measures and reduction of health disparities, as specified. It would hold plans accountable so that Medi-Cal enrollees achieve better health outcomes, regardless of the factors that determine their health.

“Health plans have reaped significant financial rewards for serving Californians in Medi-Cal. Yet, despite what the Governor’s veto might imply, for Californians on Medi-Cal, health outcomes are still different because of your ZIP code, your race, gender, or what language you speak,” de Guia said. “California cannot afford to squander its investments in Medi-Cal and expanding access to care.”

The bill would had required the department to require the plans to track and trend quality measures by specified demographic categories.

In his veto’s message to the state assembly, Brow wrote: “I am returning Assembly Bill 2275 without my signature” because “adopting these statutory requirements will duplicate current efforts while adding significant cost to Medi-Cal.”

Brown said the Department of Health Care Services is already required by federal law to have an external organization conduct periodic quality reviews of its managed care program.

However, CPEHN said that one of the problems is that existing quality improvement efforts are not standardized across plans and do not require plans to show specific improvements in care, treatment or prevention.

“Federal standards of care are extremely low, a baseline for every state regardless of size or needs,” said de Guia. “California should aim higher to ensure the wellbeing of the 1 in 3 residents who rely on Medi-Cal.

According to CPEHN, California has rightly invested in expanding Medi-Cal, which now covers 1 in 3 people in our state. Nearly 80 percent of Medi-Cal members are enrolled in a Medi-Cal managed care plan, which receive a monthly payment per enrollee for delivering health care services and as a result, those health plans have reaped significant financial rewards.

“Everyone deserves quality health care and the opportunity to lead a healthier life. We remain resolved to working with our partners and legislative leaders to make that a reality for all Californians,” de Guia said.